Surreal illustration of a bridge representing ECMO intervention for asthma and influenza.

When Asthma and Flu Collide: A Life-Saving Intervention

Nico Varela in Health & Wellness December 2025 • 4 min read.

"Discover how ECMO can be a game-changer for individuals experiencing severe asthma complications from influenza A, offering a bridge to recovery when conventional treatments fall short."

In the winter of 2009, the influenza A H1N1 virus swept across Europe, triggering typical flu symptoms for most but, in a small number of cases, it led to acute respiratory distress, necessitating intensive care. While early antiviral treatments generally proved effective, some patients required advanced extracorporeal support.

While influenza A and asthma are a dangerous combination, cases of it triggering near-fatal status asthmaticus have been virtually unheard of. Existing research recognizes asthma as a risk factor for complications. However, the scenario of influenza A leading to a severe asthma attack requiring advanced life support remains uncharted.

Here is the story of a patient presenting influenza A triggered status asthmaticus and severe pneumonia, which was not responding to traditional medical and ventilatory strategies. It emphasizes the need to save lives through prompt application of extracorporeal lung assistance.

The Case: A Turning Point with ECMO

Surreal illustration of a bridge representing ECMO intervention for asthma and influenza.

Meet a 44-year-old man with a history of asthma. He was rushed to the emergency department with sudden, intense coughing and breathing difficulties. Despite his asthma history, he hadn't been on any long-term specific therapy. Upon arrival, he was in severe respiratory distress. The exam revealed bronchospasms, reliance on accessory muscles for breathing, central cyanosis, and a racing heart. A chest X-ray pointed to pneumonia and lung hyperinflation.

Considering his age and asthma, doctors suspected influenza A H1N1. A test was conducted, and he was immediately given high-flow oxygen and intravenous steroids. Unfortunately, his condition continued to decline. A blood gas analysis revealed a pH of 6.83, a PaCO2 of 103 torr (13.73 kPa), and a PaO2/FIO2 of 100.

Ventilator Support: The patient was intubated and placed on mechanical ventilation.
Limited Improvement: His condition remained critical despite maximal medical therapy.
ECMO Consideration: Given the persistent severe respiratory distress, doctors decided on extracorporeal membrane oxygenation (ECMO).

Approximately five hours after arriving at the intensive care unit, with his condition worsening, the medical team decided to use extracorporeal lung assistance via ECMO. Cannulas were placed to drain blood from the right atrium and return it through the superior vena cava. The ECMO was initiated with a blood flow of about 5 L/minute and a gas flow of 8 L/minute. The patient was then placed on protective ventilation which reduced rates and maintained positive end-expiratory pressure.

ECMO: A Bridge to Recovery

This case underscores the importance of considering influenza A in acute respiratory distress scenarios, especially when complicated by asthma. Early antiviral treatment is crucial, but when conventional methods fail, ECMO can serve as a life-saving intervention, offering a bridge to recovery when drugs and mechanical ventilation are not enough.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What exactly is Influenza A, and why is it so concerning when someone has asthma?

Influenza A is a common viral infection that primarily affects the respiratory system. It can cause typical flu symptoms, but in some cases, it can lead to severe complications, such as acute respiratory distress and pneumonia. What makes Influenza A particularly concerning is its potential to trigger severe asthma attacks, leading to life-threatening conditions like status asthmaticus, where conventional treatments may not be enough. While asthma is recognized as a risk factor for complications from Influenza A, the scenario of it leading to severe asthma requiring advanced life support is a critical area for medical understanding and intervention.

What is status asthmaticus, and why is it so dangerous?

Status asthmaticus is a severe, prolonged asthma attack that doesn't respond to standard treatments like bronchodilators and steroids. It's a life-threatening condition where the airways narrow severely, making it extremely difficult to breathe. The importance of recognizing and treating status asthmaticus promptly cannot be overstated. If conventional treatments fail, advanced interventions like mechanical ventilation and even ECMO might be necessary to support the patient's breathing and prevent fatal outcomes. In the context of Influenza A, status asthmaticus represents a critical scenario where the infection exacerbates asthma to a dangerous level, requiring intensive care.

What is ECMO, and why is it considered a life-saving intervention in severe cases?

ECMO, or Extracorporeal Membrane Oxygenation, is a life-support system that provides respiratory and/or cardiac support to patients whose lungs or heart are so severely damaged that they cannot function on their own. It works by pumping blood outside the body, oxygenating it, and removing carbon dioxide before returning it to the patient. ECMO is significant because it can act as a bridge to recovery, allowing the lungs to rest and heal when mechanical ventilation and medications are not enough. Its use in cases of severe asthma complicated by Influenza A highlights its potential to save lives when conventional treatments fall short, offering a chance for the patient to recover from critical respiratory failure. ECMO does not treat the underlying disease but provides support while the body fights the infection.

What is mechanical ventilation and why is it important in these cases?

In this context, mechanical ventilation is a supportive treatment used to help patients breathe when they are unable to do so adequately on their own. It involves inserting a tube into the patient's trachea and using a machine to deliver oxygen and remove carbon dioxide. The importance of mechanical ventilation lies in its ability to provide respiratory support during severe respiratory distress, such as that caused by Influenza A and status asthmaticus. However, in some cases, mechanical ventilation alone may not be enough, and more advanced interventions like ECMO may be required to stabilize the patient.

What's the most important thing to remember when dealing with asthma and a flu infection at the same time?

The key takeaway is the importance of recognizing the potential for Influenza A to trigger severe asthma exacerbations leading to critical respiratory failure. Early diagnosis and prompt treatment with antiviral medications are crucial, but when conventional methods fail, considering ECMO as a life-saving intervention is essential. This approach can offer a bridge to recovery, allowing the patient's lungs to heal while providing the necessary respiratory support. The case highlights the need for clinicians to be vigilant and prepared to escalate treatment when faced with severe respiratory distress in patients with asthma and Influenza A, improving patient outcomes.